When Your Child Refuses to Go to School

It's Monday morning, time to get moving, but instead of getting ready for school your child is complaining about a stomachache, a headache, dizziness, or something similar.

Is your child sick, or just afraid to go to school?

School avoidance syndrome is one of the most common causes of vague, unverifiable symptoms in school-age children. This syndrome may be triggered by stress.

How does a parent distinguish between a real illness and anxiety? Ask yourself the following questions:

Does the child have a fever? Was he or she vomiting? Did the child have diarrhea? What was his or her condition the night before?" Does your child complain of feeling sick only on school days and then seem fine on weekends?

If no physical factors are involved, and this has happened several times before, consult your child's doctor to rule out a medical problem.

It's also important to ask the child about what's happening at school. The American Academy of Pediatrics (AAP) stresses that children may have a difficult time explaining what worries them. The AAP and American Academy of Family Physicians (AAFP) identify the following situations as school avoidance triggers:

Teasing by other children, such as being called "ugly" or "fat"

Fear of failure

Threats of physical harm from a school bully

Actual physical harm

Anxiety over using a public bathroom

Major changes at home, such as a divorce, death of a family member or pet, moving to a new home

The AAP stresses that the first step in managing school avoidance is to have the child checked by a doctor so that actual physical problems are ruled out. Vision and hearing problems, for example, may cause high levels of school-related anxiety for a child. If no physical problems are found, the doctor can help you understand the child's anxiety and develop a plan to get the child back to school.

Go, they must, but be understanding

Once physical problems are ruled out, take the time to talk and listen to your child. Be calm and sympathetic. List all the possible reasons he or she might be feeling school-related anxiety and listen to your child's response. Watch for the nonverbal behavior. Insist your child go to school, but be understanding. The longer your child stays home, the more difficult it will be for him or her to go back to school. Your child may pressure you to stay home, but be firm.

Emotional concerns

Explain to your child that he or she is in good health and his or her symptoms are most likely because of the concerns he or she has expressed to you.

Get support

Enlist the help of the school staff, including the teacher, principal, and school nurse. If you make them aware of the situation, they can help encourage your child and ease his or her anxieties. Discuss your plan for having your child return to school and work with the school personnel to try and resolve the stressful situations your child identifies.

A bully problem

If the problem is a bully or unreasonable teacher, talk to the teacher or principal. He or she may be able to make changes to lessen the pressure on your child. Be an advocate for your child.

Stand your ground

Make a commitment to be firm on school mornings when your child complains, but also make certain the child isn't really ill. The lack of recognizable symptoms (see below) is one of your best ways to evaluate his or her complaints.

Clubs and sports

Help your child develop independence by encouraging activities, such as clubs or sports, that include other children outside the home. The development of friendships and positive interests can be of great help in decreasing a child's anxieties and fears.

Recognizable symptoms: when your child should be at home

There will be times your child is ill and must stay at home. The most important question is whether your child feels well enough to participate in activities. Your child may need to see a doctor for a fever that is accompanied by other symptoms, such as a sore throat or rash. If your child doesn't seem well enough to go to school, ask your child's doctor. If your child is ill, be certain he or she is safe and comfortable, but don't make the sick day a holiday. If he or she is ill, the child should stay in bed with no special snacks or visitors. The child should always be supervised.

If school avoidance lasts for more than one week, you should seek the help of your pediatrician and school personnel. If the combination of physical and emotional issues is limiting your child's ability to function, your pediatrician may suggest that you consult with a child psychologist for additional help and support.

School avoidance is difficult for both the child and the parent. However, quick, supportive action by the parent and the appropriate use of health and school professionals can make the issue manageable.